Stress and anger management counselling

Deborah C. Escalante

Most people feel angry sometimes, but if it’s affecting your life, there are things you can try that may help.

Support is also available if you’re finding it hard to cope with stress, anxiety or depression.

If you’re not sure how you feel, try our mood self-assessment.

Symptoms of anger

Anger can cause many different symptoms. It might affect how you feel physically or mentally, or how you behave.

Some people become aggressive towards others when they’re angry. Other people hide their anger and may take it out on themselves.

It’s not always easy to recognise when anger is the reason why you’re behaving differently.

Physical symptoms

  • faster heartbeat
  • tense muscles
  • clenching your fists
  • tightness in your chest
  • feeling hot

Mental symptoms

  • feeling tense or nervous
  • being unable to relax
  • being easily irritated
  • feeling humiliated
  • resenting other people

Changes in behaviour

  • shouting
  • ignoring people or sulking
  • starting fights
  • breaking things
  • self-harming

Where to get help for anger

Non-urgent advice:

See a GP if:

  • you feel you need help dealing with your anger

They may be able to refer you to a local anger-management programme or counselling.

Anger management programmes

A typical anger management programme may involve 1-to-1 counselling and working in a small group.

A programme may be a 1-day or weekend course, or over a couple of months.

The structure of the programme depends on who provides it, but most programmes include cognitive behavioural therapy (CBT), as well as counselling.

There are also private courses and therapists who can help with anger issues. Make sure any therapist you see is registered with a professional organisation, such as the British Association for Counselling & Psychotherapy.

Where to get NHS help for stress, anxiety or depression

Referring yourself for therapy

If you need more support, you can get free psychological therapies, such as cognitive behavioural therapy (CBT), on the NHS.

You can refer yourself directly to a psychological therapies service without a referral from a GP.

Non-urgent advice:

See a GP if:

  • you’re struggling to cope with stress, anxiety or depression
  • you’ve had a low mood for more than 2 weeks
  • things you’re trying yourself are not helping
  • you would prefer to get a referral from a GP

Urgent advice:

Ask for an urgent GP appointment or call 111 if:

  • you need help urgently, but it’s not an emergency

111 can tell you the right place to get help if you need to see someone. Go to 111.nhs.uk or call: 111

Immediate action required:

Call 999 or go to A&E now if:

  • you or someone you know needs immediate help
  • you have seriously harmed yourself – for example, by taking a drug overdose

A mental health emergency should be taken as seriously as a medical emergency.

Find your nearest A&E

Causes of anger

There are many different causes of anger and it’s different for everyone.

Some common things that make people feel angry include:

  • being treated unfairly and feeling powerless to do anything about it
  • feeling threatened or attacked
  • other people not respecting your authority, feelings or property
  • being interrupted when you’re trying to achieve a goal

How you react to anger can depend on lots of things, including:

  • the situation you’re in at the moment – if you’re dealing with lots of problems or stress, you may find it harder to control your anger
  • your family history – you may have learned unhelpful ways of dealing with anger from the adults around you when you were a child
  • events in your past – people who experience traumatic, frightening or stressful events sometimes develop post-traumatic stress disorder (PTSD) which can lead to angry outbursts
  • substances such as drugs and alcohol – which make some people act more aggressively than usual

Some of the things that make you angry may not bother other people at all.

You might find it hard to explain why you feel this way but talking to someone could help you find a solution.

Find out about the 5 steps to mental wellbeing.

Important

If uncontrolled anger leads to domestic violence and abuse (violence or threatening behaviour within a relationship), there are places that offer help and support.

You can contact organisations such as:

  • Refuge
  • Women’s Aid
  • Alternatives to Violence Project (AVP)
  • Men’s Advice Line

Find out more about getting help for domestic violence and abuse.

What Is Anger Management Therapy? 

Anger is a normal human emotion that most people experience every now and then. However, if you find yourself feeling angry very often or very intensely, it may start to become a problem. 

“Rage, persistent anger, or angry outbursts can have detrimental consequences for physical health, quality of life, and relationships,” says Erin Engle, PsyD, a psychologist at Columbia University Medical Center.

“Anger management is an approach designed to help you manage the emotional and physiological arousal that accompanies anger. As it’s often not possible to change the circumstances or people that elicit anger, anger management can help you recognize your triggers for anger and learn to cope with them more effectively,” explains Engle.

The aim of anger management therapy is to help minimize stressful or anger-evoking situations, improve self-control, and help you express your feelings in a healthy manner, according to Engle.

Types of Anger Management Therapy

These are some of the different approaches to anger management therapy:

  • Cognitive Behavioral Therapy (CBT): CBT is often the treatment of choice for anger management, according to Engle. She says it can help you understand your triggers for anger, develop and practice coping skills, and think, feel, and behave differently in response to anger, so you are calmer and more in control.
  • Dialectical Behavioral Therapy (DBT): According to Engle, DBT is a form of CBT that can help individuals with intense or frequent anger regain emotional control through developing emotional regulation and distress tolerance skills, mindfulness, and effective communication in relationships.
  • Family Therapy: This form of therapy can be helpful in situations where anger is often directed at family members. It can help you work together to improve communication and resolve issues.
  • Psychodynamic Therapy: Psychodynamic therapy can help you examine the psychological roots of your anger and your response to it, so that you can identify and correct unhealthy patterns.

Your mental healthcare provider will evaluate your circumstances and specific behaviors to determine the overall approach to treatment and whether you require medication in addition to therapy, says Engle. 

Techniques

Anger management therapy techniques can involve understanding your triggers and responses to anger, learning strategies to manage or diffuse it, and changing thoughts and attitudes related to anger. Engle outlines some of these techniques below.

Identifying Triggers and Responses

Therapy can help you develop a better understanding of the factors that contribute to expressions of anger; current and past triggers for anger; your responses to it; and the consequences or aftereffects to yourself and your relationships. 

For instance, you may realize that yelling at your spouse is related to observing your parents yell, or the belief that you’ll only get what you want if you yell.

Learning Strategies to Diffuse Anger

Anger management therapy can equip you with strategies to disrupt your anger or manage your response to it through avoidance or distraction. 

Your therapist can help you problem-solve how to respond when you’re angry. Role-plays offer opportunities to practice skills such as assertiveness and direct communication that can enhance control.

Therapy can also teach you coping strategies and relaxation techniques, such as slow deep breathing, leaving the room and returning when you’re collected, or using a relaxing image to alleviate the intensity of anger.

Changing Attitude and Thought Patterns

Therapy can also involve restructuring thinking and changing attitudes related to anger, particularly if your therapist is taking a CBT approach.

Your therapist will help you examine your attitudes and ways of thinking and help identify patterns such as ruminating, catastrophizing, judging, fortune-telling, or magnifying that might exacerbate anger. 

Your therapist will also work with you to help you practice changing your response patterns. They can encourage forgiveness and compassion, offer ways to let go of hurt and disappointment, and help you repair and accept ruptured relationships.

What Anger Management Therapy Can Help With

While anger management is a form of treatment designed to help you manage anger, anger is not officially a condition that is diagnosed or defined, like depression or anxiety, for instance. However, intense, destructive, or uncontrollable anger may cause significant distress and impairment and impact safety, says Engle.

Anger management therapy can help anyone who experiences rage or has angry outbursts. Anger management therapy can help improve your:

  • Mental health: Anger can consume your focus, cloud your judgment, and deplete your energy. It can also lead to other mental health conditions such as depression and substance abuse.
  • Physical health: Anger manifests physically in the body with a surge of adrenaline, a rapid rise in heartbeat, higher blood pressure, and increased muscle tension in the form of a clenched jaw or fisted hands, says Engle. Over time, this can take a toll on your health and lead to physical health conditions.
  • Career: Anger can make it hard for you to focus on school or work and affect your performance. It can also harm your relationships with your peers. While creative differences, constructive criticism, and healthy debates can be productive, lashing out or having angry outbursts can alienate your peers and lead to negative consequences.
  • Relationships: Anger often harms loved ones the most and can take a toll on your relationships with them. It can make it difficult for them to be comfortable around you, erode their trust and respect, and be especially damaging to children.

Anger management therapy is sometimes court-ordered in case a person has committed criminal offenses, such as:

  • Assault
  • Battery
  • Disturbing the peace
  • Domestic abuse or violence
  • Rape

Benefits of Anger Management Therapy

These are some of the benefits anger management therapy can offer:

  • Identify triggers: Knowing what situations trigger your anger can help you avoid them or manage your reaction to them.
  • Change your thinking: Anger management can help you identify and change unhealthy thought patterns that fuel your anger.
  • Develop coping skills: Therapy can help you regulate your emotions, control your actions, and develop skills to help you cope with situations that trigger your anger.
  • Learn relaxation techniques: Your therapist may teach you relaxation techniques that can help you calm yourself down and relax your body and mind.
  • Solve problems: If certain situations trigger your anger repeatedly, your therapist may encourage you to look for solutions or alternatives. 
  • Improve communication: Anger management therapy can help you express your feelings in a healthy, respectful, or assertive manner, without being aggressive.

Effectiveness

According to Engle, CBT, which is often used to treat anger, is a very effective approach. CBT is an empirically-supported treatment that takes a skills-based approach to anger management, with emphasis placed on awareness of thoughts, behavioral patterns, and skill development with respect to physical and emotional reactions to anger, says Engle.

A 2017 study found that CBT was helpful to table tennis players with anger management issues. Even one year after completing treatment, participants were less likely to negatively express anger or react angrily.

A 2020 study found that anger management therapy was beneficial to patients with HIV.

Things to Consider

“As with any form of treatment, it can be beneficial to seek out the support and experience of a trained mental health professional. Professional evaluation and consultation can help identify any co-occurring mental health issues like trauma or substance use,” says Engle.

If you have a co-occurring mental health issue, it may be beneficial for you and your mental healthcare provider to determine if those disorders play a predominant role or how they can best be addressed in combination with anger management, according to Engle. 

Depending on your co-occurring issues, your mental healthcare provider will determine an appropriate treatment plan and whether or not you require medication, explains Engle.

How to Get Started

If you find yourself arguing often, becoming violent or breaking things, threatening others, or getting arrested because of incidents related to your anger, you may need to seek anger management therapy.

Look for a trained mental health professional who specializes in this form of treatment.

Depending on your preferences, you can choose to opt for individual treatment or group therapy. Individual therapy sessions offer more privacy and one-on-one interaction whereas group therapy sessions can help you feel like you’re not going through this alone.

A Word From Verywell

Anger is a universal emotion that often arises in response to threat, loss of power, or injustice, says Engle. She explains that anger is not necessarily negative, though it can be detrimental at uncontrollable levels, given the behaviors likely to follow anger such as throwing things, walking out, attacking others, saying things you later regret, or acting passive-aggressively.

Anger can take a toll on your health, relationships, and career. Anger management therapy can help you regulate your emotions, maintain self-control, develop coping strategies, and communicate effectively.

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